Nineteen patients received tumoricidal doses of radiation and subsequently underwent mandibular endosseous implant reconstruction, followed by dental rehabilitation with complete arch fixed osseoprostheses. Eight of the 19 patients also underwent autogenous bone graft reconstruction for mandibular discontinuity. A surgical and prosthetic protocol for irradiated head and neck oncology patients is presented. The 10-year retrospective study of 19 consecutively treated patients revealed an endosseous implant survival of 99%, dental osseoprosthesis continuous service of 100%, and successful bone graft reconstruction of 89%.